I’m Dr Sébastien Beley, urological surgeon and andrologist based in Paris. Today, I’d like to talk about a subject that affects many men but is often misunderstood: the pain associated with Lapeyronie’s disease. More specifically, I’m going to talk about the different treatment options available to relieve this pain, with particular emphasis on an innovative and promising method: shockwaves.

Lapeyronie’s disease is a urological condition characterized by the formation of fibrous plaques on the penis, which can lead to deformity, curvature and often embarrassing pain. In some cases, this pain can be intense and difficult to manage. In this article, I’ll explain why conventional drug treatments aren’t always enough, and how shockwaves can offer an interesting alternative, particularly in the painful inflammatory phases of the disease.

Understanding pain in Lapeyronie’s disease

Lapeyronie’s disease can take many forms. In some patients, there are few symptoms, with a simple curvature of the penis and no noticeable pain. In others, it is accompanied by an active inflammatory process that causes significant pain, often described as constant discomfort or acute pain during erections or even at rest.

This inflammatory pain is linked to the formation of fibrous plaques and the inflammatory reaction that surrounds them. It can become so intense that some patients find it difficult to perform simple gestures, such as getting dressed, as the simple contact of clothing on the penis can trigger disabling pain. This type of pain requires specific, tailored treatment.

Conventional drug treatments: their limitations

When pain is present, the first line of treatment often relies on medication. Here are the main categories used:

• Simple analgesics: such as paracetamol, often prescribed to relieve mild to moderate pain.
• Vitamins and supplements: notably vitamin E (Toco-500), which is sometimes used in Lapeyronie’s disease for its antioxidant properties and its potential to limit the progression of fibrosis.
• Anti-inflammatories: these can be steroidal (corticosteroids) or non-steroidal (NSAIDs). Among the latter, a specific category called coxibs (selective COX-2 inhibitors) is often used, notably celecoxib (marketed under the name Celebrex).

These treatments can be effective in some cases, but they have their limits. For some patients, the pain remains intense despite these drugs. What’s more, both steroidal and non-steroidal anti-inflammatory drugs can have undesirable side effects when taken over a long period of time. As a result, when these treatments fail to control pain, other solutions need to be considered.

Shock waves: an innovative treatment for Lapeyronie’s pain

Faced with this pain, which is resistant to conventional treatments, an alternative therapeutic approach has emerged: extracorporeal shockwave therapy. Initially used for lithotripsy, i.e. the fragmentation of kidney stones, this treatment has been adapted for other pathologies, including Lapeyronie’s disease.

What is shock wave treatment?

Shockwave treatment involves applying high-energy acoustic waves to the diseased area. These waves cause controlled microtrauma, stimulating blood circulation, promoting tissue repair and reducing inflammation. In urology, this procedure is used to reduce pain and improve quality of life for patients suffering from Lapeyronie’s disease.

How do shockwaves affect pain?

In the context of Lapeyronie’s disease, shockwaves enable :

• Reduce local inflammation around fibrous plaques.
• Reduce pain by acting on pain-sensitive nerve fibres.
• Promote scar tissue resorption and plaque flexibility.
• Limit disease progression, particularly in the active inflammatory phases.

This non-invasive approach provides effective pain relief without the need for prolonged, often poorly tolerated, drug treatments.

Which patients can benefit from shockwave therapy?

This treatment is particularly indicated for patients :

• Intense pain associated with Lapeyronie’s disease, especially when it interferes with daily activities such as wearing clothes.
• In whom conventional drug treatments (analgesics, anti-inflammatories) have proved insufficient.
• Having an active inflammatory phase of the disease, where pain is predominant.

It’s essential to consult a specialized urologist to assess your situation and determine whether this treatment is right for you. Personalized care is always the key to a good result.

Advantages and precautions of shockwave treatment

The benefits of treatment

Shockwave therapy offers several advantages:

1. Non-invasive: no need for surgery, reducing risks and recovery time.
2. Few side effects: unlike drugs, shockwaves have no systemic side effects.
3. Proven effectiveness: many patients experience a significant reduction in pain after just a few sessions.
4. Improved quality of life: reduced pain means greater comfort in daily life and intimate relationships.

Precautions to take

Like any medical procedure, shockwave treatment must be supervised by a competent professional. Here are a few points to consider:

• It is important to have a precise diagnosis of Lapeyronie’s disease and its progressive stage.
• Treatment is not a miracle solution, and must be part of a comprehensive approach to disease management.
• For some patients, several sessions are required to achieve optimum results.
• This treatment should be avoided in the event of local infections or uncontrolled coagulation disorders.

Practical advice for patients with painful Lapeyronie’s disease

If you suffer from Lapeyronie’s disease and experience significant pain, here are some recommendations to help you manage your condition:

• Consult a specialist: an experienced urologist will be able to offer you a precise diagnosis and appropriate follow-up.
• Don’t settle for conventional treatments if the pain persists: talk to your doctor about possible alternatives, such as shockwaves.
• Avoid prolonged self-medication: some anti-inflammatory or analgesic drugs can have long-term side effects.
• Adopt a healthy lifestyle: a balanced diet, moderate physical activity and stress management can help improve your overall well-being.
• Support yourself psychologically: Lapeyronie’s disease can affect self-confidence and intimacy. Consult a psychologist or join a support group.

Future prospects and innovations in the treatment of Lapeyronie’s disease

Medical research continues to advance, offering Lapeyronie’s disease patients ever more effective and less invasive solutions. Promising avenues include :

• Combination treatments: combine shockwaves with other therapies, such as collagenase injections, to improve results.
• New molecules: development of drugs targeting more precisely the mechanisms of fibrosis and inflammation.
• Regenerative therapy: using stem cells or growth factors to promote tissue repair.
• Personalizing treatments: better understanding patient profiles to adapt therapies to each individual case.

These advances are encouraging, and testify to a growing interest in improving the overall management of this disease.

Conclusion

The pain associated with Lapeyronie’s disease is a difficult reality for many patients. While conventional drug treatments can sometimes provide relief, they are not always sufficient, especially in severe inflammatory forms. In such cases, extracorporeal shockwave treatment is an interesting alternative for reducing pain, improving quality of life and avoiding the long-term side effects of drugs.

It is essential to consult a specialized urologist for a precise diagnosis and appropriate treatment. If you suffer from persistent pain associated with Lapeyronie’s disease, don’t hesitate to discuss this treatment option. Together, we can find the best strategy to help you live a more comfortable and fulfilling life.

For more information on male sexual health, Lapeyronie’s disease, and other urological disorders, I invite you to follow my content regularly. Take care and see you soon.